STUDIES IN PATIENTS WITH ADRENOCORTICAL HYPERFUNCTION. III.IN VITROSECRETION OF STEROIDS BY HUMAN ADRENAL GLANDS*

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Abstract
Twenty adrenal glands surgically obtained from 12 patients with adrenocortical hyperfunction were investigated for their in vitro steroid production during incubation. Five steroids could regularly be extracted from the incubation medium, and the amounts were quantitatively determined. The production rate for the sum of the 5 steroids fluctuated widely from 9.20 to 67.57 μg. per Gm. per hour during the first hour of incubation; during the following hours the rate generally decreased. In the adrenals of patients with Cushing's syndrome, hydrocortisone accounted for 62.8–85.1 per cent of the total production, corticosterone for 4.2–12.0 per cent, cortisone for 5.4–12.1 per cent, and 11β-hydroxyandrostenedione for 4.2–12.4 per cent. In the adrenals of patients with adrenal virilism, hydrocortisone contributed less (15.5–56.0 per cent) to the total steroid production, but corticosterone (20.6–44.9 per cent) and 11β-hydroxyandrostenedione (18.5–35.4 per cent) contributed a greater portion; cortisone contributed 1.2–18.1 per cent. Aldosterone production in the adrenals of 7 patients without significant hypertension ranged from 0.4 to 2.4 per cent, but was 4.8 to 6.6 per cent in the 4 patients with systolic blood pressures above 120mm. Hg. When the amounts of the steroids produced during incubation were compared to the urinary excretions of the corresponding steroids in the various patients prior to surgery, a rough correlation could be observed. The release of all 5 steroids into the incubation medium was increased by the addition of various ACTH preparations to the medium, and decreased by the addition of amphenone.